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World J Gastrointest Surg. Mar 27, 2026; 18(3): 115621
Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.115621
Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.115621
Correlation between the initiation of early enteral nutrition and anastomotic fistula after pancreaticoduodenectomy
Bei Yan, Li-Qun Zhang, Department of General Surgery, First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Yi-Qing Shen, Department of Comprehensive Surgery the Transformation Center, First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Author contributions: Yan B research implementation and paper drafting; Zhang LQ data collation and analysis; Shen YQ research design and paper review.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of First Affiliated Hospital of Soochow University, No. 20251270.
Informed consent statement: All study participants and their legal guardians provided written informed consent before recruitment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Yi-Qing Shen, Chief Nurse, Department of Comprehensive Surgery the Transformation Center, First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou 215006, Jiangsu Province, China. 1149750425@qq.com
Received: November 21, 2025
Revised: December 25, 2025
Accepted: January 22, 2026
Published online: March 27, 2026
Processing time: 126 Days and 3.5 Hours
Revised: December 25, 2025
Accepted: January 22, 2026
Published online: March 27, 2026
Processing time: 126 Days and 3.5 Hours
Core Tip
Core Tip: This retrospective cohort study, involving data from 200 patients who underwent pancreaticoduodenectomy, revealed that initiating early enteral nutrition (EEN) ≤ 24 hours versus > 72 hours postoperatively, was an independent protective factor against total anastomotic leakage and clinically relevant (grade B/C) pancreatic fistulas. EEN was also associated with significantly improved nutritional status (serum albumin, prealbumin, and transferrin levels), accelerated recovery of gastrointestinal function, and shortened hospital stay. These findings challenge traditional delayed feeding practices and support the integration of EEN into enhanced recovery pathways for this major surgery.